Early Diagnosis and Clinical Significance of Acute Cardiac Injury - Under the Iceberg: A Retrospective Cohort Study of 619 Non-critically Ill Hospitalized COVID-19 Pneumonia Patients
Abstract Rationale Coronavirus disease 2019 (COVID-19) can cause a viral pneumonia together with other extrapulmonary complications. Acute cardiac related injury (ACRI) is common in hospitalized COVID-19 patients.Objective To explain the pathological mechanism of ACRI and improve the treatment strategy by retrospectively observing the factors associated with ACRI and factors affecting the prognosis of ACRI with COVID-19 at an early stage.Methods 619 COVID-19 patients were from Tongji Hospital, Wuhan. Student’s t test was used for continuous variables while Pearson χ2 test for categorical factors. Univariable and multivariable logistic regression models were applied to estimate odds ratio (OR) with 95% confidence interval (CI).Results Among the 619 OOS Level-I hospitalized COVID-19 patients, 102 (16.5%) were defined as ACRI (stage-1: 59 cases, stage-2: 43 cases). 50% of ACRI patients developed into severe cases and 25 patients died(CFR=24.5%), 42 times that of non-ACRI patients. Elderly (OR=2.83, P<0.001), HTN (OR=2.09, P=0.005), γ-globulin (OR=2.08, P=0.004), TCM (OR=0.55, P=0.017), PLT (OR=2.94, P<0.001) and NLR (OR=2.20, P=0.004) were independently correlated with ACRI. SBP ⩾ 140, dyspnea, DM, smoking history were correlated with ACRI-stage2 only. In the prognostic subgroup analysis of ACRI patients, γ-globulin treatment could prolong LOS (29.0 ± 7.2 days Vs 23.5 ± 8.1 days, P=0.004). TCM (OR=0.26, P=0.006), SBP ⩾ 160 (OR= 22.70, P=0.005), male (OR=2.66, P=0.044) were associated with severe illness while corticosteroids treatment (OR=3.34, P=0.033) and male (OR=4.303, P=0.008) with death. Surprisingly, we found the mortality of non-elderly patients is higher than elderly (32.4% VS 20.0%, P=0.164), and both IKF and RASI treatment were not correlated with any prognostic indicators including severe, death and LOS.Conclusion This study observed that several non-traditional issues were associated with early cardiac injury in COVID-19 while many traditional cardiovascular risk factors were not. Besides elderly and male, hypertension was confirmed to be the most important risk factor..
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Preprint| Erscheinungsjahr: |
2021 |
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| Erschienen: |
2021 |
| Enthalten in: |
bioRxiv.org - (2021) vom: 10. Jan. Zur Gesamtaufnahme - year:2021 |
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| Sprache: |
Englisch |
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| Beteiligte Personen: |
Xie, Yang [VerfasserIn] |
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| Links: |
Volltext [kostenfrei] |
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| doi: |
10.1101/2020.07.06.20147256 |
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| PPN (Katalog-ID): |
XBI018312268 |
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| 245 | 1 | 0 | |a Early Diagnosis and Clinical Significance of Acute Cardiac Injury - Under the Iceberg: A Retrospective Cohort Study of 619 Non-critically Ill Hospitalized COVID-19 Pneumonia Patients |
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| 520 | |a Abstract Rationale Coronavirus disease 2019 (COVID-19) can cause a viral pneumonia together with other extrapulmonary complications. Acute cardiac related injury (ACRI) is common in hospitalized COVID-19 patients.Objective To explain the pathological mechanism of ACRI and improve the treatment strategy by retrospectively observing the factors associated with ACRI and factors affecting the prognosis of ACRI with COVID-19 at an early stage.Methods 619 COVID-19 patients were from Tongji Hospital, Wuhan. Student’s t test was used for continuous variables while Pearson χ2 test for categorical factors. Univariable and multivariable logistic regression models were applied to estimate odds ratio (OR) with 95% confidence interval (CI).Results Among the 619 OOS Level-I hospitalized COVID-19 patients, 102 (16.5%) were defined as ACRI (stage-1: 59 cases, stage-2: 43 cases). 50% of ACRI patients developed into severe cases and 25 patients died(CFR=24.5%), 42 times that of non-ACRI patients. Elderly (OR=2.83, P<0.001), HTN (OR=2.09, P=0.005), γ-globulin (OR=2.08, P=0.004), TCM (OR=0.55, P=0.017), PLT (OR=2.94, P<0.001) and NLR (OR=2.20, P=0.004) were independently correlated with ACRI. SBP ⩾ 140, dyspnea, DM, smoking history were correlated with ACRI-stage2 only. In the prognostic subgroup analysis of ACRI patients, γ-globulin treatment could prolong LOS (29.0 ± 7.2 days Vs 23.5 ± 8.1 days, P=0.004). TCM (OR=0.26, P=0.006), SBP ⩾ 160 (OR= 22.70, P=0.005), male (OR=2.66, P=0.044) were associated with severe illness while corticosteroids treatment (OR=3.34, P=0.033) and male (OR=4.303, P=0.008) with death. Surprisingly, we found the mortality of non-elderly patients is higher than elderly (32.4% VS 20.0%, P=0.164), and both IKF and RASI treatment were not correlated with any prognostic indicators including severe, death and LOS.Conclusion This study observed that several non-traditional issues were associated with early cardiac injury in COVID-19 while many traditional cardiovascular risk factors were not. Besides elderly and male, hypertension was confirmed to be the most important risk factor. | ||
| 700 | 1 | |a Chen, Sichun |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Xueli |e verfasserin |4 aut | |
| 700 | 1 | |a Li, Baige |e verfasserin |4 aut | |
| 700 | 1 | |a Zhang, Tianlu |e verfasserin |4 aut | |
| 700 | 1 | |a He, Xingwei |e verfasserin |4 aut | |
| 700 | 1 | |a Sun, Ningling |e verfasserin |4 aut | |
| 700 | 1 | |a Wang, Luyan |e verfasserin |4 aut | |
| 700 | 1 | |a Zeng, Hesong |e verfasserin |4 aut | |
| 700 | 1 | |a Shen, Yin |e verfasserin |4 aut | |
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